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Diaphragmatic herniation following donor hepatectomy for living donor liver transplantation: a serious complication not given due recognition
Ann Hepatobiliary Pancreat Surg 2017 Nov;21(4):232-6
Published online November 30, 2017
Copyright © 2017 Ann Hepatobiliary Pancreat Surg.

Rajiv Lochan1, Rehan Saif2, Naveen Ganjoo2, Mallikarjun Sakpal1, Charles Panackal1, Kaiser Raja1, Jayanth Reddy1, Sonal Asthana1, and Mathew Jacob2

1Aster Integrated Liver Care Group, Aster CMI Hospital, Bangalore, Karnataka,2Aster Integrated Liver Care Group, Aster MedCity Hospital, Kochi, Kerala, India
Received May 10, 2017; Accepted July 7, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
A clear appreciation of benefits and risks associated with living donor hepatectomy is important to facilitate counselling for the donor, family, and recipient in preparation for living donor liver transplant (LDLT). We report a life-threatening complication occurring in one of our live liver donors at 12 weeks following hemi-liver donation. We experienced five donor complications among our first 50 LDLT: Clavien Grade 1, n=1; Clavien grade 2, n=3; and Clavien grade 3B, n=1. The one with Clavien grade 3B had a life-threatening diaphragmatic hernia occurring 12 weeks following hepatectomy. This was promptly recognized and emergency surgery was performed. The donor is well at 1-year follow-up. Here we provide a review of reported instances of diaphragmatic hernia following donor hepatectomy with an attempt to elucidate the pathophysiology behind such occurrence. Life-threatening donor risk needs to be balanced with recipient benefit and risk on a tripartite basis during the counselling process for LDLT. With increasing use of LDLT, we need to be aware of such life-threatening complication. Preventive measures in this regard and counselling for such complication should be incorporated into routine work-up for potential live liver donor. (Ann Hepatobiliary Pancreat Surg 2017;21:232-236)
Keywords : Minimizing donor risk; Living liver donor hepatectomy; Liver transplantation; Diaphragmatic hernia


November 2018, 22 (4)